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Biopsy Reports & MELD Score: Part 2

In my last article, I spoke about biopsy results and getting your MELD score. MELD score is something your doctor will speak of periodically… and it can be confusing. Even though it was explained to me, I still have a hard time processing it. So, if you are like me and still confused, don’t worry. This is just something your doctor will monitor and keep you up to date with.

What is MELD score?

The Model for End-Stage Liver Disease (MELD) system is used to evaluate end-stage patients waiting for liver transplant. This scale is used primarily for adult liver patients waiting for liver transplantation. For younger patients (children), doctors will use another evaluation system.1

How is MELD score calculated?

In order to calculate your MELD score, you will need to know some of your blood test results. Up-to-date blood work is needed to calculate a more accurate, up-to-date score.1

Creatinine

Creatinine levels measure kidney function. Typically, normal levels of creatinine are usually around 0.6 to 1.2 mg/dL in adult men and 0.5 to 1.1 mg/dL in adult women.1,2

Bilirubin

Bilirubin is a yellow pigment found naturally in blood and stool. Typically, normal values of total bilirubin are from 0.3 to 1.0 mg/dL.1

INR

The INR test measures blood clotting. A result of 1.0 up to 1.5 is considered normal.1

Sodium

The sodium test, also referred to as Na+ test, shows the level of sodium in the blood.

MELD score formulas

There are two formulas for estimating the MELD score. The original formula is still used in non-US transplant societies. The new, improved formula was introduced in January 2016, and includes the serum sodium level.1

The original formula

The original forumla for MELD Score = 10 *[(0.957 * ln (Creatinine)) + (0.378 * ln (Bilirubin)) + (1.12 * ln (INR))] + 6.43.

The new formula

The new formula for MELD score = MELD score + 1.32 * (137 – sodium) – 0.033 * MELD Score * (137 – sodium).

Understanding MELD score results

MELD scores are usually interpreted in terms of 90-day mortality. Typical scores and their possible meaning are given below. For example, a MELD score of 40 would indicate a 71% 90-day mortality rate.1 Your doctor will be able to interpret and monitor your MELD score.

  • MELD score of 40 = 71% mortality
  • MELD score between 30 and 39 = 53% mortality
  • MELD score between 20 and 29 = 20% mortality
  • MELD score between 10 and 19 = 6% mortality
  • MELD score equal or less than 9: 1.9% mortality

What do my results really mean?

Understanding the MELD system can be complicated. For myself, I knew that a lower the number is considered better. If my number began to rise, that showed signs of complications and that my liver was struggling more. It was explained to me that the MELD score shows how well the liver excretes bile (bilirubin), how the kidneys are functioning, and if the liver is able to clot blood normally (INR).

Watching and waiting

If you have a good liver specialist, they will be watching this closely and will directing you as the progression goes. Do not focus all your time on numbers.  I was told to keep-up a good diet of leafy greens, low sodium, low fat, limited fried foods, limited red meats, and most of all… no alcohol.

As patients, we play a key role in our liver healthThe doctors can only do so much. But, if we eat well, get rest, and exercise, we can help protect our livers. We DO have that control.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The HepatitisC.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Haponiuk B. MELD Calculator (Model for End-Stage Liver Disease). Omni Calculator. https://www.omnicalculator.com/health/meld. Accessed March 25, 2019.
  2. Creatinine blood test. MedlinePlus. https://medlineplus.gov/ency/article/003475.htm. Accessed March 25, 2019.

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